LD 585
pg. 2
Page 1 of 5 An Act to Establish a Statewide Primary and Preventive Health Care Program ... Page 3 of 5
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LR 50
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set in paragraph A to the extent necessary to bring
the program within the program budget.

 
(3)__If program expenditures are reasonably
anticipated by the commissioner to fall below the
program budget, the commissioner shall raise the
maximum eligibility level set in paragraph A to the
extent necessary to provide coverage to as many
persons as possible within the fiscal constraints of
the program budget.

 
(4) The commissioner shall give at least 30 days'
notice of the proposed change in maximum eligibility
level to the joint standing committee of the
Legislature having jurisdiction over appropriations
and financial affairs and the joint standing
committee of the Legislature having jurisdiction over
health and human services matters.

 
C.__Subject to the other requirements in this subsection,
a person who is resident in the State is eligible for the
program unless that person:

 
(1)__Is eligible for coverage under the MaineCare
program;

 
(2)__Is covered under a group health insurance plan
or under health insurance, as defined in Section 2791
of the federal Public Health Service Act, 42 United
States Code, Section 300gg(c) (Supp. 1997); or

 
(3)__Is eligible under Title 5, section 285 for
health coverage under the state employee health
insurance program as an individual or as a member of
a family.

 
D.__Notwithstanding changes in the maximum eligibility
level determined under paragraphs A and B, the following
requirements apply to enrollment and eligibility:

 
(1)__A program participant must be enrolled for a 12-
month enrollment period. Prior to the end of each 12-
month enrollment period the department shall
redetermine eligibility for continuing coverage; and

 
(2) Persons of higher family income may not be covered unless
persons of lower family income are also covered.__This
subparagraph may not be applied to disqualify a person during
the 12-month enrollment period.__A person of higher family
income may be disqualified at the end of the 12-month
enrollment


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